Trends and issues in medical surgical Nursing

Introduction

  1. The entire field of health care is changing day by day.
  2. These changes occurs at rapid rate.
  3. The focus of medical -surgical nursing is not limited to a disease or a body system but focus on holistic in nature.
  4. Medical -surgical nursing is a speciality of nursing that requires a specific skills such as analytical, technical,administrative and organizational skills.
  5. According to academy of medical –surgical nurses, it is evolving as a speciality and is the largest group of practicing professional. 

Definitions

  • Medical-surgical -Medical-surgical nursing involves the nursing  care of adult patients whose conditions or disorders are treated medically/pharmacologically, or surgically It is also defined as the diagnosis and treatment of human responses of individuals and groups to actual or potential health problems.
  • Medical Surgical Nursing-  Medical-surgical nursing is a Branch of nursing specialty area concerned with the care of adult patients in a broad range of settings (Medical or Surgical)
  • Trend- A general direction in which a situation is changing or developing. - Oxford Advanced Learners Dictionary
  • Issues- An important topic that people are discussing. A problem or worry that somebody has with some thing.

 Trends in Medical Surgical Nursing   

  1. Quantification of nursing care costs
  2. Reduced length of stay
  3. Increasing Reliance On High Technology
  4. Requirement of advanced nursing knowledge
  5. Need for collaboration and communication
  6. Innovation in care planning through computerization
  7. Unification of practice and education 
  8. Greater investment in research and development
  9. Role blurring and shared competencies
  10. New areas of nursing specialization
  11. Nursing seen as a cost effective approach to health
  12. Telenursing
  13. Robotic nursing
  14. Aerospace nursing
  15. Simulation
  16. Gene Therapy
  17. Community based nursing 
  18. Political Trends in Medical Surgical Nursing

1. Quantification of nursing costs

  1. Quantification of nursing contribution to patient care can be used to determine the cost of providing care to specific patients
  2. Quantifying nursing time requires the identification of the level of nursing care necessary for each patient.
  3. The patient care plan is an integral part of the justification of nursing care costs 

2. Reduced length of stay

  • The provision of personalized care must be planned and provided with continuity as the quality of care time decreases.
  • Many patients who leave the hospital earlier are still need of health care.
  • Aggressive discharge planning must begin on admission.
  • An effective coordinated plan of care can help ensure continuity of care.

3. Increase reliance on high technology

  • The evolving technological advances in nursing are the wave of the future in healthcare. Emerging new technologies in EHRs,  apps and software development are becoming increasingly popular as more hospitals and facilities integrate them into their health system.

4. Requirement of advanced nursing knowledge

  • The medical –surgical nurse needs greater clinical expertise, maturity, clinical thinking ability, assertiveness and patient management skills to handle patients.
  • Certification acknowledges the nurses attaintment of predetermined standards established by the certifying groups. 

 5. Need for Collaboration and communication 

  • The health care delivery becomes more complex and economically centered that need communication and collaboration among health care professionals.
  • Only through collaboration between departments, services, and facilities the nursing care can be delivered effectively. 

6. Innovation in planning care through computerisation

  • Nurses believe that their better time can be spend at the bedside giving patient care rather than filling out paperwork
  • Studies shows that institutions using computers reports increases number of plan of care being generated. 

7. Unification of practice and education

  • The Unification Model directs nursing education, research, and practice. Unification is not only a philosophical approach but also an organizational structure that operationalizes the interdependence among education, research and practice. 

8. Greater investments and developments

  • In the recent years the budget allocation for nursing research has been increased in the view of increasing the quality of nursing care. 

9. Role blurring and shared competencies

  • Nowadays the role of nurses is not clearly defined
  • The work of nurses are shared with other departments.

10. New areas of nursing specialization-

  • M.Sc. in Oncology
  • M.Sc. in Forensic Science
  • Nurse Practitioner
  • Course Advance Skill Training ACLS, PALS,NALS , ATCN New Courses


11. Nursing -cost effective approach

  • The nursing procedures we are doing are evidenced based and cost effective when compare to medical treatment and procedures. 

12. Telenursing

  • Tele nursing or telehealth nursing uses technologies to provide nursing services through computers and mobile devices.
  • It allows patients to connect with their nurses through mobiles devices,computers,applications etc.

13. Robotic nursing

  • Robots are used in nursing for monitoring elderly patient via video ,helps in positioning,feeding,shifting etc.

14. Simulation -Simulation is the “process of designing a model of a real system and conducting experiments with this model for the purpose of either understanding the behavior of the system and/or evaluating various strategies for the operation of the system. 

15. Aerospace nursing-Aerospace nurses embrace the art and science of the profession and incorporate critical thinking skills and specialized knowledge into their professional practice and interprofessional collaboration with members of the aerospace team.

16. Gene Therapy- These types of vaccine technologies have been developed over more than 20 years using translational research for use against cancer or diseases caused by genetic disorders but the COVID-19 vaccines are the first licensed drugs to prevent infectious diseases using RNA vaccine technology. 

17. Community based nursing

  • The health care delivery concept is now changing from hospital centered to community based nursing. 


18. Political Trends in Medical Surgical Nursing-

Florence Nightingale was first nurse who exerted political pressure on government and she had influential pressure in reforming hospitals and implementing public health policies. Nurses were also involved in formulating the health care policy where they are working. In 1990 Nurses became volved in politics at local, state and national level. Nurses in all practice areas are affected by public policy on daily basis.

Issues in medical surgical nursing

  1. Staff shortage
  2. Meeting patients expectations
  3. Long work hours
  4. Workplace violence
  5. Workplace hazards
  6. Scope of practice
  7. Personal health 

1. Staff shortages

  • The world health organization estimates that there will be shortage of 1.1 million nurses throught out the world.
  • This may cause disturbances in health care system. 

2. Meeting the patients expectations

  • Due to advanced technology and awareness, the patients expectation are not met.
  • This causes job dissatisfaction among nurses. 

3. Long work hours

  • Shortage of nurses forces the nurses to work for long hours which causes physical and mental disturbances.

4. Workplace violence

  • Violence against nurses has been a pandemic. According to the World Health Organization (WHO), “between 8 and 38% of nurses suffer from health-care violence at some point of their career”.Compared to other workplaces, health care workers have a higher risk of getting physically, sexually, or psychologically injured. 

5. Workplace hazards

  • Needle stick injuries,sharp tools, and heavy equipments may risk the nurses health and life. 

6. Scope of practice

  • The scope of practice for nurses makes nurses to work in a defined area of practice.
  • Till now there is no prescribed scope of practice for nurses in India. 

7. Personal health

  • Working in a stressfull health care system causes physical and mental disequilibrium. 
     

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